Role Description The Claims Adjudicator II position will receive, examine, verify and input submitted claim data, determine eligibility status, and review and adjudicate claims within established timeframes. This position utilizes multiple systems in order to perform the day-to-day functions of processing medical, disability, vision and dental claims, as well as, provider and member driven inquiries. - Screens claims for completeness of necessary information - Verifies participant/dependent eligibility - Interprets the plan benefits from the Summary Plan Description (SPD)/Plan Documents - Codes basic information and selects codes to determine payment liability amount - Evaluates diagnoses, procedures, services, and other submitted data to determine the need for further investigation in relation to benefit requirements, accuracy of the claim filed, and the appropriateness or frequency of care rendered - Determines the need for additional information or documentation from participants, employers, providers and other insurance carriers - Handles the end to end process of Medicare Secondary Payer (MSP) files - Processes Personal Injury Protection (PIP) claims - Requests overpayment refunds, maintains corresponding files and performs follow-up actions - Handles verbal and written inquiries received from internal and external customers - Processes Short Term Disability claims - Adjudicates claims according to established productivity and quality goals - Achieve individual established goals in order to meet or exceed departmental metrics Qualifications - 3 ~ 5 years of direct experience minimum in a medical claim adjudication environment - Working knowledge and experience in interpretation of benefit plans, including an understanding of limitations, exclusions, and schedule of benefits - Experience with eligibility verification, medical coding, coordination of benefits, and subrogation and its related processes - Experience with medical terminology, ICD10 and Current Procedural Technology (CPT) codes - Fluency (speak and write) in Spanish, preferred Requirements - Salary range for this position: Hourly $20.36 - $24.97 - Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. - Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) Fully Remote, after 1-week training onsite in Oak Brook, IL. (Travel and Lodging paid for by UHH) Benefits - Medical - Dental - Vision - Paid Time-Off (PTO) - Paid Holidays - 401(k) - Pension - Short- & Long-term Disability - Life - AD&D - Flexible Spending Accounts (healthcare & dependent care) - Commuter Transit - Tuition Assistance - Employee Assistance Program (EAP)

Role Description As a Claims team leader at Reserv, you will be responsible for a team of claims professionals managing claims in your experienced line of business. We want your background and experience to deliver operational effectiveness, particularly in leveraging technology and analytics to drive better efficiencies and performance. You will serve a critical role with the team, the customers, and the client. The high-performing team you will manage will service several clients as part of our Core Team. You will maintain high quality standards, and compliance with regulatory, internal, and external contractual SLAs. This position requires exceptional leadership skills, and a foundational understanding of claims with experience handling and managing a team of individuals. Qualifications - Highly motivated and growth-oriented - Subject matter expert in commercial claims, including coverage and litigation - Tech-oriented with proven results leveraging technology and analytics - Passionate claims professional who cares about their team and customer experience - Empathetic leader promoting the ‘Reserv Way’ and values - Sense of urgency without working at all hours - Creative in challenging existing assumptions and leveraging technology - Curious and decisive in making informed decisions - Problem solver focused on operational workings while keeping the big picture in mind - Anti-status quo, taking action to improve processes - Communicative and comfortable with phone communications throughout the claims process - Possesses a sense of humour Requirements - Chartered Institute Qualifications minimum of DIP CII or equivalent - 10+ years in insurance claims management experience in multiple lines of business - 5+ years of management experience, preferably in a remote environment - Comfortable with technology to evolve claims systems and processes - Demonstrated commitment to quality, accuracy, and attention to detail - Integrity, ethics, and accountability in handling confidential information Benefits - Generous health-insurance package with nationwide coverage, vision, & dental - 401(k) retirement plan with employer matching - Competitive PTO policy for employee well-being - Generous family leave policy after 8 months of continuous work - Work from anywhere to facilitate work-life balance - Apple laptop, large second monitor, and other quality-of-life equipment - Listen to your feedback to enhance the adjuster role - Work toward reducing administrative work from the adjuster role - Foster a culture of empathy, transparency, and empowerment in a remote-first environment

Role Description The Claims Support and Administrative Coordinator is responsible for supporting the claims team. The individual assists claimants, responds to inquiries, provides administrative support on claim files, prepares reports, and provides data and information to other departments, and manages a small caseload of title clearance matter files to a final resolution with supervisor oversight. Essential Duties and Responsibilities - Facilitate initial communication between claims and claimants. - Notify active agents of any new claims received unless there are extenuating circumstances. - Responsible for sending acknowledgement letters to appropriate parties. - Create monthly, or as needed, claim reports. - Provide legal research support to claims team when applicable. - Assist claims in conducting legal research to assist in case preparation. - Assist with drafting department policies and procedures. - Organize and maintain file system, correspondence, legal research, and other records. - Assist with requested claim audits. - Ensure deadlines are met. - Attend a conference, training session, or webinar related to the title industry to stay current. - Conduct thorough investigation on assigned low to medium difficulty level claim files, gather data, analysis of title policy and other products, and provide a recommendation for the best resolution for the claim. - Communicate with agent, if appropriate, of any sizeable loss to be paid on a file. - Examine title and develop strategy for resolution of claim in most cost-effective manner. - Determine need to retain defense counsel to defend the company or its insured in litigation and engage outside counsel with required approvals. - Evaluate liability and establish recommendations for settlement and expense reserves. - Resolve claims that do not require the defense of the company or that are covered claims through investigation, corrective documents, negotiation, or payment. - Draft agreements and corrective documents for review and approval by appropriate senior manager or, if appropriate, Claims Management Committee. - Review and approve invoices for costs and attorneys' fees. - Evaluate claims for recoupment options. - Review files assigned as part of company reserve process and update financial reserves accordingly. - Draft educational and training materials for seminars and present at seminars. - Support team to educate and train agents on claim concerns and how to avoid claim issues. Competencies - Achievement Focus: Demonstrates persistence and ability to overcome obstacles. Measures self against standard of excellence. Recognizes and acts on opportunities. Sets and achieves challenging goals. Takes calculated risks to accomplish goals. - Communications: Exhibits good listening and comprehension skills. Expresses ideas and thoughts in written and verbal form. Keeps others adequately informed. Selects and uses appropriate communication methods. - Managing Customer Focus: Develops new approaches to meeting customer needs. Establishes customer service standards. Monitors customer satisfaction. Promotes customer focus. Always calm and respectful in difficult situations. - Planning and Organization: Integrates changes smoothly. Plans for additional resources. Prioritizes and plans work activities. Sets goals and objectives. Uses time efficiently. Works in an independent and organized manner. - Problem Solving: Develops alternative solutions. Gathers and analyzes information skillfully. Identifies problems in a timely manner. Resolves problems in early stages. Works well in group problem solving situations. Decisive and accountable. Qualifications - Paralegal with one to three years related experience and/or training in title insurance or real estate industry preferred. - Read, analyze and interpret business, professional, technical or governmental documents. - Write reports, business correspondence and procedure manuals. - Effectively present information and respond to questions from managers, customers and the public. - Solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. - Highly proficient in Microsoft Suite and internet research. - Paralegal certification. Supervisory Responsibilities This job has no supervisory responsibilities. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the workplace is typically moderate. This position is a remote position. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - While performing the duties of this job, the employee is regularly required to sit. - The employee is frequently required to use hands to finger, handle, or feel and talk or hear. - The employee is occasionally required to stand and walk. - The employee must be able to occasionally lift and/or move up to 10 pounds. - Specific vision abilities required by this job include close vision.

Role Description - Highly motivated and growth-oriented. - Excited by the prospect of building a tech-driven claims organization. - Passionate adjuster who cares about the customer and their experience. - Empathetic; exercises empathy and patience towards everyone interacted with. - Sense of urgency at all times, without working at all hours. - Creative; finds the right exit ramp for the resolution of claims in the insured's best interest. - Enjoys conflict; believes it should be conversational rather than adversarial. - Curious; wants to know the whole story to make informed decisions early. - Anti-status quo; takes action to improve processes. - Communicative; values sharing thoughts and ideas. - Possesses a sense of humor; understands the challenges of claims work. Qualifications - Minimum of 3 years’ experience with motor claims, including commercial and motor trade. - Experience in fraud within the motor space. - Proven background in credit hire negotiation. - Ability to deal with delegated authority and client philosophies. - Cert CII (or willingness to work toward it). - Ability to analyze and evaluate complex data and make sound decisions based on established guidelines, policies, and procedures. - Curious and motivated by problem solving and questioning the status quo. - Desire to engage in learning opportunities and continuous professional development. - Willingness to travel for client and claims needs. Requirements - Experience in commercial motor and motor trade claims – repair, capture, intervention, third-party & property damage. - Experience in credit hire negotiations. - Ability to handle claims from cradle to grave. - Attention to detail and ability to provide quality interactions with stakeholders, clients, and customers to high standards. - Excellent customer service skills. - Strong organizational skills and ability to prioritize workload. - Ability to work to system-driven SLAs and workflows. - Strong communication skills – both written and oral. - Comfortable working in a fluid role in a fast-paced environment. Benefits - Generous health-insurance package with nationwide coverage, vision, & dental. - 401(k) retirement plan with employer matching. - Competitive PTO policy – we want our employees fresh, healthy, happy, and energized! - Generous family leave policy after 8 months of continuous work. - Work from anywhere to facilitate work-life balance. - Apple laptop, large second monitor, and other quality-of-life equipment. - Listen to feedback to enhance and improve upon the challenges of an adjuster and the claims role. - Work toward reducing and eliminating administrative work from the adjuster role. - Foster a culture of empathy, transparency, and empowerment in a remote-first environment.